Objective To investigate the utilization of damage control surgery (DCS) in treatment of the severe abdominal traumas.Methods The clinical data of 56 patients with severe abdominal traumas treated by DCS (Emergency operation,fluid resuscitation and definitive operation were used gradually.)from January 2011 to January 2013 in Department of General Surgery,Taizhou People's Hospital were retrospectively analyzed.Results Of the 56 patients,52 were cured and discharged from hospital,the clinical curative rate was 92.9％; 4 patients dead.Conclusions Abdominal traumas under going operations by applying the damage control surgery significantly increased the clinical curative rate.

Objective To investigate the role of intestinal fatty acid binding protein (IFABP) and blood procalcitonin (PCT) in diagnosis of traumatic Intestinal rupture in early stage.Methods The clinical data of 58 patients with abdominal injuries admitted from May 2012 to April 2016 were retrospectively analyzed.All 58 patients were divided into intestinal rupture group (n =21) and nonintestinal rupture group (n =37).The concentrations of IFABP and PCT were detected,analyzed and compared between two groups at different intervals.Results The IFABP and PCT in intestinal rupture group were significantly higher than those in non-intestinal rupture group.The IFABP and PCT in intestinal rupture group significantly decreased after operations.There were significantly differences in IFABP and PCT between two groups at admission,4 hours after admission,preoperative period,and 24 hours after operation.However,these differences disappeared at 72 hours after operation.At the same time,the accuracy rate 92.4％,sensitivity 96.3％,specificity 72.8％ found in combination of these two biomarkers were significantly higher than those of IFABP and PCT measured separately.Conclusions The combination of IFABP and PCT detection can be used as an indicator for the diagnosis of traumatic intestinal rupture in the early stage.

Objective:To analyze the clinical features of chronic active Epstein-Barr virus infection (CAEBV) in order to reduce the rates of underdiagnosis and misdiagnosis of this disease.Methods:The CAEBV related literatures of PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, WanFang Database and Chongqing VIP since the first literature published (May 1987) until August 29, 2020 were searched. The clinical characteristics, laboratory examinations, outcome and causes of death of CAEBV patients were retrospectively analyzed. Statistical analysis was performed by Mann-Whitney U test, chi-square test or Fisher′s exact probability test. Results:A total of 111 patients aged 22.0 (10.0, 39.0) years were included from 46 articles. There were 64 cases (57.7%) in the age ≥18 years group and 47 cases (42.3%) in the age <18 years group. Fever, splenomegaly, hepatomegaly, and lymph node enlargement were common clinical manifestations, with incidences of 95.5%(106/111), 84.7%(94/111), 57.7%(64/111) and 56.8%(63/111), respectively. The incidences of rash and hepatomegaly in the age ≥18 years group were 3.1%(2/64) and 45.3%(29/64), respectively, which were both lower than those in patients aged <18 years group (27.7%(13/47) and 74.5%(35/47), respectively), while the incidence of abnormal liver biochemical indexes was higher (45.3%(29/64) vs 23.4%(11/47)). The differences were all statistically significant ( χ2=13.957, 9.436 and 5.643, respectively, all P<0.05). Of the 70 patients with follow-up outcomes, 38(54.3%) died and 32(45.7%) survived. The causes of death included gastrointestinal bleeding, severe infection, respiratory failure, liver failure, etc. The incidences of splenomegaly in the death and survival groups were 92.1%(35/38) and 68.8%(22/32), respectively. The difference was statistically significant ( χ2=6.266, P<0.05). Of 21 death and 17 survival cases in the age <18 years group, 15(71.4%) and two cases were combined hemophagocytic lymphohistiocytosis (HLH), respectively, with statistical significance ( χ2=13.527, P<0.01). Of the 90 patients whose HLH-related information was available, 38(42.2%) combined HLH and 52(57.8%) without HLH, with 36.8%(14/38) and 65.4% (34/52) of males, respectively. The difference of gender distribution was statistically significant ( χ2=7.187, P=0.007). The treatment regimens of the 111 CAEBV patients during the course of disease were various, but the detailed information was lacking. Conclusions:The clinical manifestations of CAEBV are diverse. CAEBV can be complicated with fatal complications, lacks of effective treatment, and shows poor prognosis. It is necessary to actively carry out related research to improve the understanding of the disease, and explore effective treatment and reduce mortality.

Objective To evaluate the fairness of the configuration of stroke centers in China,and to provide a reference basis for further standardizing and improving the treatment of stroke patients,ensuring medical quality and medical safety.Methods Gini coefficient,agglomeration and Lorenz curve were used to measure the equity of the current configuration of stroke centers in China.Spatial information was analyzed and processed through geographic information system(GIS)technology,combining visualization effects and geographic analysis functions to discover spatial differences in their distribution.Results Currently,there are 1 414 stroke centers in China.The Lorenz curves for the distribution of stroke center allocations by population in all 34 provincial administrative regions of China lie below the fair line.The Gini coefficients and Lorenz curves for the various provincial administrative regions of China show a large disparity in the inequity of resource allocation across the region,with more than half of the provincial administrative regions having stroke centers with an HRAD/PAD＜1,and the distribution of stroke centers relative to the agglomeration of Insufficient population.The nearest-neighbor indices of stroke centers were 0.58(P＜0.01)in China,respectively,which belonged to a typical aggregation pattern with significant zonal differences.Conclusion The planning of stroke centers in China has been effective,but it still needs to be continuously promoted.In response to the situation that demographic fairness is better than geographic,it should be optimized and adjusted in conjunction with urban planning and be adapted to the local conditions with preceding by education and awareness-raising,to cope with the significant differences in the fairness of the configurations of the different provincial administrative districts.

Objective To evaluate the fairness of the configuration of stroke centers in China,and to provide a reference basis for further standardizing and improving the treatment of stroke patients,ensuring medical quality and medical safety.Methods Gini coefficient,agglomeration and Lorenz curve were used to measure the equity of the current configuration of stroke centers in China.Spatial information was analyzed and processed through geographic information system(GIS)technology,combining visualization effects and geographic analysis functions to discover spatial differences in their distribution.Results Currently,there are 1 414 stroke centers in China.The Lorenz curves for the distribution of stroke center allocations by population in all 34 provincial administrative regions of China lie below the fair line.The Gini coefficients and Lorenz curves for the various provincial administrative regions of China show a large disparity in the inequity of resource allocation across the region,with more than half of the provincial administrative regions having stroke centers with an HRAD/PAD＜1,and the distribution of stroke centers relative to the agglomeration of Insufficient population.The nearest-neighbor indices of stroke centers were 0.58(P＜0.01)in China,respectively,which belonged to a typical aggregation pattern with significant zonal differences.Conclusion The planning of stroke centers in China has been effective,but it still needs to be continuously promoted.In response to the situation that demographic fairness is better than geographic,it should be optimized and adjusted in conjunction with urban planning and be adapted to the local conditions with preceding by education and awareness-raising,to cope with the significant differences in the fairness of the configurations of the different provincial administrative districts.

Objective To evaluate the fairness of the configuration of stroke centers in China,and to provide a reference basis for further standardizing and improving the treatment of stroke patients,ensuring medical quality and medical safety.Methods Gini coefficient,agglomeration and Lorenz curve were used to measure the equity of the current configuration of stroke centers in China.Spatial information was analyzed and processed through geographic information system(GIS)technology,combining visualization effects and geographic analysis functions to discover spatial differences in their distribution.Results Currently,there are 1 414 stroke centers in China.The Lorenz curves for the distribution of stroke center allocations by population in all 34 provincial administrative regions of China lie below the fair line.The Gini coefficients and Lorenz curves for the various provincial administrative regions of China show a large disparity in the inequity of resource allocation across the region,with more than half of the provincial administrative regions having stroke centers with an HRAD/PAD＜1,and the distribution of stroke centers relative to the agglomeration of Insufficient population.The nearest-neighbor indices of stroke centers were 0.58(P＜0.01)in China,respectively,which belonged to a typical aggregation pattern with significant zonal differences.Conclusion The planning of stroke centers in China has been effective,but it still needs to be continuously promoted.In response to the situation that demographic fairness is better than geographic,it should be optimized and adjusted in conjunction with urban planning and be adapted to the local conditions with preceding by education and awareness-raising,to cope with the significant differences in the fairness of the configurations of the different provincial administrative districts.

Objective To evaluate the fairness of the configuration of stroke centers in China,and to provide a reference basis for further standardizing and improving the treatment of stroke patients,ensuring medical quality and medical safety.Methods Gini coefficient,agglomeration and Lorenz curve were used to measure the equity of the current configuration of stroke centers in China.Spatial information was analyzed and processed through geographic information system(GIS)technology,combining visualization effects and geographic analysis functions to discover spatial differences in their distribution.Results Currently,there are 1 414 stroke centers in China.The Lorenz curves for the distribution of stroke center allocations by population in all 34 provincial administrative regions of China lie below the fair line.The Gini coefficients and Lorenz curves for the various provincial administrative regions of China show a large disparity in the inequity of resource allocation across the region,with more than half of the provincial administrative regions having stroke centers with an HRAD/PAD＜1,and the distribution of stroke centers relative to the agglomeration of Insufficient population.The nearest-neighbor indices of stroke centers were 0.58(P＜0.01)in China,respectively,which belonged to a typical aggregation pattern with significant zonal differences.Conclusion The planning of stroke centers in China has been effective,but it still needs to be continuously promoted.In response to the situation that demographic fairness is better than geographic,it should be optimized and adjusted in conjunction with urban planning and be adapted to the local conditions with preceding by education and awareness-raising,to cope with the significant differences in the fairness of the configurations of the different provincial administrative districts.

Objective To evaluate the fairness of the configuration of stroke centers in China,and to provide a reference basis for further standardizing and improving the treatment of stroke patients,ensuring medical quality and medical safety.Methods Gini coefficient,agglomeration and Lorenz curve were used to measure the equity of the current configuration of stroke centers in China.Spatial information was analyzed and processed through geographic information system(GIS)technology,combining visualization effects and geographic analysis functions to discover spatial differences in their distribution.Results Currently,there are 1 414 stroke centers in China.The Lorenz curves for the distribution of stroke center allocations by population in all 34 provincial administrative regions of China lie below the fair line.The Gini coefficients and Lorenz curves for the various provincial administrative regions of China show a large disparity in the inequity of resource allocation across the region,with more than half of the provincial administrative regions having stroke centers with an HRAD/PAD＜1,and the distribution of stroke centers relative to the agglomeration of Insufficient population.The nearest-neighbor indices of stroke centers were 0.58(P＜0.01)in China,respectively,which belonged to a typical aggregation pattern with significant zonal differences.Conclusion The planning of stroke centers in China has been effective,but it still needs to be continuously promoted.In response to the situation that demographic fairness is better than geographic,it should be optimized and adjusted in conjunction with urban planning and be adapted to the local conditions with preceding by education and awareness-raising,to cope with the significant differences in the fairness of the configurations of the different provincial administrative districts.

Objective To evaluate the fairness of the configuration of stroke centers in China,and to provide a reference basis for further standardizing and improving the treatment of stroke patients,ensuring medical quality and medical safety.Methods Gini coefficient,agglomeration and Lorenz curve were used to measure the equity of the current configuration of stroke centers in China.Spatial information was analyzed and processed through geographic information system(GIS)technology,combining visualization effects and geographic analysis functions to discover spatial differences in their distribution.Results Currently,there are 1 414 stroke centers in China.The Lorenz curves for the distribution of stroke center allocations by population in all 34 provincial administrative regions of China lie below the fair line.The Gini coefficients and Lorenz curves for the various provincial administrative regions of China show a large disparity in the inequity of resource allocation across the region,with more than half of the provincial administrative regions having stroke centers with an HRAD/PAD＜1,and the distribution of stroke centers relative to the agglomeration of Insufficient population.The nearest-neighbor indices of stroke centers were 0.58(P＜0.01)in China,respectively,which belonged to a typical aggregation pattern with significant zonal differences.Conclusion The planning of stroke centers in China has been effective,but it still needs to be continuously promoted.In response to the situation that demographic fairness is better than geographic,it should be optimized and adjusted in conjunction with urban planning and be adapted to the local conditions with preceding by education and awareness-raising,to cope with the significant differences in the fairness of the configurations of the different provincial administrative districts.

Objective To evaluate the fairness of the configuration of stroke centers in China,and to provide a reference basis for further standardizing and improving the treatment of stroke patients,ensuring medical quality and medical safety.Methods Gini coefficient,agglomeration and Lorenz curve were used to measure the equity of the current configuration of stroke centers in China.Spatial information was analyzed and processed through geographic information system(GIS)technology,combining visualization effects and geographic analysis functions to discover spatial differences in their distribution.Results Currently,there are 1 414 stroke centers in China.The Lorenz curves for the distribution of stroke center allocations by population in all 34 provincial administrative regions of China lie below the fair line.The Gini coefficients and Lorenz curves for the various provincial administrative regions of China show a large disparity in the inequity of resource allocation across the region,with more than half of the provincial administrative regions having stroke centers with an HRAD/PAD＜1,and the distribution of stroke centers relative to the agglomeration of Insufficient population.The nearest-neighbor indices of stroke centers were 0.58(P＜0.01)in China,respectively,which belonged to a typical aggregation pattern with significant zonal differences.Conclusion The planning of stroke centers in China has been effective,but it still needs to be continuously promoted.In response to the situation that demographic fairness is better than geographic,it should be optimized and adjusted in conjunction with urban planning and be adapted to the local conditions with preceding by education and awareness-raising,to cope with the significant differences in the fairness of the configurations of the different provincial administrative districts.